An unusual presentation of pediatric acute lymphoblastic leukemia

Abstract

Acute lymphoblastic leukemia (ALL) is one of the most common hematological malignancies occurring in children. We report an interesting case of ALL with an unusual presentation. This 3-year-old boy came with a 6 month history of multiple pathological fractures, generalized osteopenia and vertebral compression. All the possible causes responsible for this condition were ruled out. His complete blood count which was normal initially evolved into cytopenias. His physical examination revealed generalized lymphadenopathy and hepatosplenomegaly. The complete blood count showed pancytopenia with blasts in peripheral smear. Bone marrow aspirate was suggestive of B ALL. Pediatric ALL patients usually present with symptoms due to cytopenias, fever and bone pains. Although asymptomatic skeletal involvement may be seen in 40-60% of patients at presentation, pathological fractures and vertebral compressions are very rare. Therefore a high index of suspicion is needed to diagnose such cases. Moreover, these patients are usually associated with good prognostic features.

Atypical Presentation of Acute Lymphoblastic Leukemia in a 7 Year Old Child

“…The usual clinical presentation of ALL in children includes fever, hepatosplenomegaly, lymphadenopathy, bone pain and bleeding [2]. Musculoskeletal manifestations are seen in 20-40 % patients with ALL [2,4].…”

“…Musculoskeletal manifestations are seen in 20-40 % patients with ALL [2,4]. Osteoporosis and reduced bone mineral density had been described in ALL during diagnosis and treatment and even after completion of chemotherapy [5].…”

“…Children with ALL have good prognosis with overall survival rate of 80 % [1].A child with ALL usually presents with fever, hepatosplenomegaly, lymphadenopathy, bone pain and bleeding [2]. The peripheral smear shows pancytopenia with or without blasts.…”

Protean Neuroophthalmic Presentations of Common Childhood Malignancies—A Report of Two Cases

“…They often puzzle clinicians and pose interesting diagnostic challenges. [1][2][3][4][5][6][7] We describe two unique neuroophthalmological presentations of common childhood malignancies in this report.…”